Podcasts about ASO

Ua aumaia le fe'au fa'amanuia a le palemia, Anthony Albanese, mo le Tausaga Fou, na ia toe tepa ai i le osofa'iga terorisi i Bondi Beach i le Aso 14 o le masina nei.

What if one tiny visual tweak could send your app viral?

Deux gros objectifs par an, des courses “carottes” pour rester motivé, une PPG solide pour éviter les blessures… et un plan qui s'adapte aux imprévus : c'est ça, une vraie saison pensée comme un athlète de haut niveau. Dans cet épisode, RMC Running reçoit Yannick Dupouy, coach d'Étienne Daguinos (vainqueur des 20 km de Paris, sélectionné aux Mondiaux de cross) et membre de My Running Club. Avec le maître Yodu, ils vous ouvrent les coulisses de la planification : comment organiser vos cycles (foncier, spécifique, affûtage, régénération) ? Combien de semaines pour préparer un semi, un marathon, un 10 km ? Que faire quand une blessure fait dérailler le plan ? Pourquoi la planification équivaut à 60-70% de votre performance ? De quoi préparer 2026 avec méthode… et aller chercher vos meilleurs chronos.Dans le bon plan dossard, nous vous offrons un dossard pour une nouvelle course parisienne : le "10km Montmartre AG2R-La Mondiale" qui aura lieu le 18 janvier prochain. Nous recevons Thomas Delpeuch, responsable des grands événements sportifs chez ASO. Rendez-vous sur notre compte Instagram pour décrocher ce magnifique dossard. Dans le bon plan matos, tentez de gagner la toute nouvelle veste de chez Gorewear, la veste imperméable "concurve Gore-Tex". Ludovic Thepin nous rend visite pour nous parler de ce vêtement technique, idéal avec les conditions météos. Rendez-vous sur le Instagram "RMC RUNNING" pour la remporter !

Headway is one of the biggest spenders in mobile marketing, generating hundreds of millions in revenue through its insanely effective Web2App funnel.In this breakdown, Steve P. Young and Igor Lyubimov, CEO, web2wave, reveal the exact flow Headway uses to turn cold traffic into paying users — and how you can model it for your app.You'll discover:✅ The psychology behind high-converting Web2App funnels✅ How Headway turns quiz-takers into subscribers✅ The “winback” email sequence that drives extra revenue✅ Smart upsells & pricing tricks that boost LTV✅ Why longer funnels sometimes convert betterIf you're spending money on Meta, TikTok, or influencer ads, this strategy could completely change your ROAS.Try web2wave: https://web2wave.comSpecial App Masters Offer: Get the lowest plan for $199/month + concierge service to help you build your funnel — mention 'App Masters' on your call with the web2wave team or in chat after creating your account

Saturday, December 20, 2025 - Five days till Christmas, 11 days left to raise funds to CURE SYNGAP1 AES was exceptional in many ways, here are a few: Rare & SYNGAP1 were both very visible, posters with our Logo and names of staff were seen! Posters: https://www.linkedin.com/posts/graglia_syngap1-curesyngap1-activity-7408291479187755008-rMru Our conference was standing room only and had investors!  Even got a mention in their research report! https://www.investing.com/news/analyst-ratings/cantor-fitzgerald-reiterates-overweight-rating-on-camp4-therapeutics-stock-93CH-4403281 ProMMiS Launch was a massive win for patients.  Collaboration. Praxis and Lundbeck recruited for exciting drugs and CAMP4 talked about their ASO and recruiting next year. Our community's presence was felt well into AES. Aaron's post on growth! https://www.facebook.com/aaron.j.harding.5/posts/pfbid0231DtMVUtkZa4eXLv8C8qbf4xEN95aRP1xJ8sGNNvun7aDuUyZVatMWUjjigdXfg1l    Pre-register now for Denver: cureSYNGAP1.org/Pre26   Fundraising. We are YTD $1.68M which is below $1.86M in '23 and $1.97M in '24.  We need to really double down on fundraising for the next two weeks and into next year.  Support our campaign at curesyngap1.org/unlock   ACTION ALERT

In this live session, Steve P. Young will perform a real-time ASO audit using ASOMobile.net, the powerful all-in-one tool for keyword research, competitor analysis, and app visibility tracking.He'll analyze 3 different apps of our App Founders Community members, each with unique ASO challenges — and show how to find keyword opportunities, optimize metadata, and boost organic downloads:

App Store optimization is often treated as a checklist item — update keywords, run a few tests, maybe layer on some paid traffic. But when those pieces operate in isolation, teams miss the real opportunity: using paid and organic together as a single, feedback-driven system. In this episode, we're sharing an App Talks interview with David Quinn, VP of Strategy and Partnerships at Gummicube. David reframes ASO not as a standalone discipline, but as a full-funnel acquisition and conversion engine — one where keyword strategy, creative testing, and paid campaigns continuously inform one another. Today's topics include: Why ASO only works when keyword strategy, creative testing, and paid campaigns are treated as one system How paid campaigns can actively support organic rankings instead of cannibalizing them Using Apple Search Ads taps and share of voice to influence App Store search performance Structuring Apple Ads campaigns and ad groups for clearer insights and better optimization The role of custom product pages in improving conversion and lowering paid acquisition costs Links and Resources: David Quinn on LinkedIn Gummicube website Business Of Apps - connecting the app industry Quotes from David Quinn “ASO isn't any one of these things in a vacuum — it's the combination of keyword updates, A/B testing, and paid campaigns, and the learnings you get from all of them together.” “If you launch paid campaigns before setting up your metadata, you're missing a huge opportunity for the algorithm to understand what you should rank for.” “Paid search placements can help organic performance because taps are signals — if users choose your app more often, the store learns to rank it higher.” Host Business Of Apps - connecting the app industry since 2012

Het wachten is bijna voorbij. Zaterdag nemen Wout van Aert en Mathieu van der Poel het tijdens de Wereldbeker van Antwerpen eindelijk weer eens tegen elkaar op in een cross op het hoogste niveau, waarbij ze beiden ook nog eens geen belemmeringen qua blessures kennen. Maar ook het wegwielrennen brengt veel nieuws met zich mee. Je hoort het in de nieuwe WielerFlits Podcast!We beginnen namelijk met nieuws vers van de pers. Unibet Rose Rockets heeft geen wildcard gekregen voor Parijs-Nice. Op zich geen bittere noodzaak, maar misschien wel een teken aan de wand richting een eventuele wildcard voor de Tour de France. Beide wedstrijden vallen immers onder de auspicien van organisator ASO. Nu deelde Parijs-Nice de laatste tijd altijd al ‘slechts' vier wildcards uit, terwijl ze er in totaal zeven mogen uitdelen. Wat betekent het missen van Parijs-Nice voor een eventuele deelname aan de Tour de France voor de troepen van Bas Tietema en co?Ook staan we uitgebreid stil bij het vele nieuws dat onze verslaggever Youri raapte bij onder andere Red Bull-BORA-hansgrohe, Lidl-Trek en UAE Emirates XRG. Zo weet wereldkampioen Tadej Pogacar al welke zeven ploeggenoten hem komende zomer in de Tour de France zullen bijstaan, en was er met name bij Lidl-Trek toch wel sprake van wat consternatie. Je hoort er alles over in deze aflevering. Maxim stipt vervolgens aan dat Pogacar wel heel weinig koersdagen rijdt, waarop Youri invult dat dit ook voor Remco Evenepoel geldt. En vooral: dat ze elkaar ontlopen.Uiteraard komen ook Mathieu van der Poel en Wout van Aert ook ruimschoots aan bod. De wereldkampioen veldrijden maakte afgelopen weekend zijn debuut in dit crossseizoen, zijn Belgische aartsrivaal zal dat komend weekend ook doen. Het mooiste van alles: ze nemen het zaterdag meteen tegen elkaar op in Antwerpen en daarna binnen twee weken nog eens vier keer. Wat zeggen de data van de krachtsverhoudingen tussen de twee kemphanen? En kan Thibau Nys hun niveau benaderen? Je hoort het allemaal in een nieuwe aflevering van de WielerFlits Podcast!

In this episode, we're sharing a recording of a live coaching call with one of our clients, Ben, CTO & Co-Founder at Ertigo, a company behind a portfolio of yoga and flexibility apps.Ben's already nailed the basics of ASO and early user acquisition, but now he's ready to take things to the next level, scaling efficiently, building a long-term growth roadmap, and choosing the right tools for sustainable success.Together with Steve P. Young, they break down the ideal mobile app growth framework, the difference between growing a single app vs. an entire portfolio, and what every founder should do before investing heavily in paid channels.You will discover:✅ The ideal app growth framework, when to move from ASO → ASA → Meta/TikTok✅ How portfolio growth differs from scaling a single app✅ How to set up your social media channels to fuel app installs✅ The truth about MMP tools, Adjust vs. AppsFlyer, and which one fits your stage✅ The #1 mistake founders make when transitioning to paid marketingLearn More:Check out:https://apps.apple.com/id/app/chair-yoga-for-seniors-sitfit/id6741904178 Connect with Ben:https://www.linkedin.com/in/boonya-kitpitak/You can also watch this video here: https://www.youtube.com/live/2QNlnFOaOtYWant expert guidance to grow your app? Book a quick call with App Masters:https://appmasters.com/contact-us/Get training, coaching, and community: https://appmasters.com/academy/*********************************************SPONSORSYou don't need a big team or budget to succeed in ASO.ASOMobile helps you find the best keywords, track your rankings, and see what competitors are doing — all in one simple platform.And if you want to keep growing, use the promo code APPMASTERS40 to get 40% off any plan, for any period at http://bit.ly/49y6rEP*********************************************Launch a high-performing branded Web Shop in minutes—or build a fully custom storefront without the hassle.Xsolla's modular solution reduces platform fees, supports 1,000+ global payment methods, and ships with built-in LiveOps and customization tools—so every purchase puts more revenue back in your studio's pocket.Check out now: https://tinyurl.com/43hda5tf*********************************************Follow us:YouTube: ⁠AppMasters.com/YouTube⁠Instagram: ⁠@App MastersTwitter: ⁠@App MastersTikTok: ⁠@stevepyoung⁠Facebook: ⁠App Masters⁠*********************************************

For years, mobile marketers have been navigating a storm of signal loss, rising UA costs, siloed data, and an explosion of tools that promise growth but rarely deliver clarity. Now, with 2026 on the horizon — and budgets tightening even further — one question keeps resurfacing: How do you drive confident, profitable app growth in the year ahead? In this App Talk special of the Business of Apps Podcast, David Murphy speaks with Eoin Hallahan, Chief Revenue Officer at SplitMetrics, about what the mobile growth landscape is really demanding of teams as they prepare for 2026. Eoin lays out the new realities UA and ASO managers are facing: deeper signal loss, more channel fragmentation, and rising internal pressure to deliver results without expanding headcount. You'll hear how SplitMetrics is reshaping app growth with a unified approach to Apple Ads, App Store Optimization, and AI — including SplitMetrics Iris, an AI agent trained specifically on mobile marketing data. Eoin explains how Iris gives UA teams a strategic edge by turning competitor activity, keyword trends, and performance blind spots into instant, actionable guidance. If you're reevaluating your growth playbook for 2026 — or looking for a smarter, faster way to connect the dots across UA, ASO, and analytics — this conversation is essential listening. Let's dive in: here's Eoin Hallahan, CRO at SplitMetrics. Today's topics include: Why app growth is getting harder heading into 2026, from signal loss to budget pressure and fragmented data. How UA and ASO workflows need to evolve, and why aligning paid and organic strategies is now essential. What SplitMetrics Iris does, and how an AI agent built specifically for mobile marketing changes decision-making. How AI speeds up competitive research, keyword strategy, and campaign optimization — with examples from Flow and NordVPN. Where app growth is heading next, including automation, real-time intelligence, and a new operating model for mobile growth. Links and Resources: Eoin Hallahan on LinkedIn SplitMetrics website SplitMetrics Iris Business Of Apps - connecting the app industry Quotes from Eoin Hallahan “Mobile app marketing is hard, and SplitMetrics exists to make it easy for our customers and to drive growth.” “Conditions today are more volatile and unpredictable than ever, with trends shifting all the time — marketers need a new way of working to keep up.” “Iris isn't just automation; it's a new operating system for mobile growth — it flips the model from dashboards and guesswork to instant, actionable clarity.” Host Business Of Apps - connecting the app industry since 2012

OPEN HEAVENSMATALA LE LAGI MO LE ASO SA 7 TESEMA 2025(tusia e Pastor EA Adeboye) Manatu Autu: O le uiga moni o le tulaga siitia(The true meaning of promotion)Tauloto Tusi Paia: 1 Timoteo 3:1 “O le ‘upu moni lenei, ‘āfai e naunau se tasi i le faiva o le epikopō, e mana‘o o ia i le galuega lelei.”‭‭Faitauga - Tusi Paia: 1 Peteru 5:1-4A siitia tulaga o tagata ia latou galuega i le lalolagi, e mafai ona faaeaina i latou i tulaga e faaitiitia ai galuega e fai na i lo'o tulaga i lalo ifo sa i ai muamua. I le mālō o le Atua, o le uiga moni o le siitia o le tulaga o le faaopoopoina o galuega.Ou te manatua le tele o tausaga ua mavae a o lei avea a'u ma ta'ita'i aoao o le RCCG, sa ou vaai i le ta'ita'i o tatalo i le po atoa i le isi taimi ma sa ou popole. Sa ou manatu o se tulaga faaletonu matuiā ua tupu ma sa ou fesili ia te ia po o le a se mea ua faaletonu. Sa ata ma fai mai o le a ou malamalama i se aso. I le tele o tausaga mulimuli ane ina ua avea a'u ma ta'ita'i aoao, na o'u malamalama ai auā o lea fo'i ua o'u tatalo i le po atoa. A siitia e le Atua lou tulaga i totonu o lana galuega, o le a faaopoopoina galuega ma fa'aositaulaga e te manaomia e faatino ai le galuega. Fa'ata'ita'iga, ou te le'i toe fai Aso o Tamā faatasi ma lo'u aiga vagana ai le 2020 i le taimi o le vavao o le fa'ama'i coronavirus.Ou te matua'i fiafia lava pe a ou maua se avanoa ou te moe ai i lo'u lava moega auā ua seāseā maua lea avanoa. Ua laititi le taimi ou te malolo ai na i loo le taimi a'o to'a selau afe tagata o le ekalesia. A siitia oe e le Atua i lana galuega, aua ne'i faaosofia lou fiafia i le tino, a ia e faautauta auā ua tatau ona tupu tele lou malosi fa'aleagaga ia avea ai oe ma faamanuiaga i ni agaga se tele. E tatau ona e saili ia e latalata i le Atua na i loo le faamaimau taimi e fiafia ai ma tagata. A faaeaina se uso i le mālō o le Atua, o se valaau e tele atu ma faigata tiute. O lea, a e vaai i ni faifeau lelei a le Atua ua faaeaina tulaga i le galuega a le Atua, aua e te mata'u'a ia i latou. O le maualuga e siitia i ai lou tulaga i le mālō o le Atua, o le tele lea o galuega lelei e tatau ona e faia. E taua fo'i le iloa, a faaeaina e le Atua tagata ma avatu ia i latou tiute e tele, na te saunia fo'i mo i latou le alofa tunoa e tele. E leai se mea o le a e fefe ai I le tele o tiute fai e omai faatasi ma le faaeaina a le Atua auā o le a ia fa'afaula'i ia te outou le alofa tunoa uma e pei ona Ia siitia maualuga outou, (2 Korinito 9:8;). E pei ona o tatou faitau muamua I le fuaiupu tauloto o le asō, fai mai Paulo, o lou mana'o I se tulaga maualuga atu I le mālō o le Atua o se tulaga lelei. O lea la, e tatau ona e loto atu ia siitia pea lou tulaga e le Atua ao fa'aauau pea ona e auauna mo Ia. O le tulaga siitia i le malo o le Atua o le valaau e siitia matafaioi ma galuega faatino, I le suafa o Iesu, Amene.

Si siempre has querido ver cómo son las campañas de las apps, este es tu episodio, ya que Paula Fernández nos lo explica con todo detalle. RL Episodio: https://ppccast.com/podcast/266-publicidad-para-apps-con-paula-fernandezPPCFest: ppcfest.comPPCCast+: ppccast.com/plusPatrocinadoresRaiola Networks: ppccast.com/raiolaData Feed Watch: ppccast.com/datafeedConvertiam: ppccast.com/convertiam

The secret sauce behind profitable consumer subscriptions?Meet the Subscription Value Loop — a framework so good, it's basically the “Conjoined Triangles of Success”… but it actually works.

ASO is getting harder, with more AI-generated apps, more competition, and more developers fighting for the same high-volume keywords. But there's one core ASO principle that still moves the needle… and most beginners miss it completely.In this video, Steve P. Young breaks down the single most important element of ASO you MUST nail if you want real organic downloads:

Most founders focus only on the US market, but what if the fastest path to scaling your app is right in your own country?In this episode, we're joined by Suphasit Thongniam, CEO of NubCal, an AI-powered calorie tracking app that helps users calculate calories by simply snapping a photo of their meal.NubCal has seen exceptional growth in Thailand thanks to strong localization, deep cultural understanding, and a highly effective Meta Ads strategy. Suphasit will share how doubling down on your home market can help you achieve product–market fit, improve retention, and build sustainable growth before expanding globally.If you're struggling to stand out in the crowded US market, this episode will give you a proven blueprint for winning with localization and scaling beyond borders.You will discover:✅ How to use localization to achieve product–market fit in your home country✅ How NubCal built traction by understanding Thai culture, language, and user behavior✅ Meta Ads strategies that work in growing international markets✅ How non-US markets can offer lower competition and high ROILearn More:Check NubCal: https://nubcal.comUse this special code for a 20% discount on NubCal's annual package:02C353You can also watch this video here: ⁠https://www.youtube.com/live/h1zUyMondkUWant expert guidance to grow your app? Book a quick call with App Masters:https://appmasters.com/contact-us/Indie App Santa: https://www.indieappsanta.comGet training, coaching, and community: ⁠https://appmastersacademy.com/*********************************************SPONSORSYou don't need a big team or budget to succeed in ASO.ASOMobile helps you find the best keywords, track your rankings, and see what competitors are doing — all in one simple platform.From November 17 to 23, you can try ASO Max, the most advanced plan from ASOMobile — completely free, no credit card needed.And if you want to keep growing, use the promo code APPMASTERS40 to get 40% off any plan, for any period at ASOMobile.net*********************************************

This week, the Krewe is joined by Loretta Scott (aka KemushiChan on YouTube Channel) for a personal, insightful, and often funny look at what it's like raising kids in Japan as an American parent. We dig into birth experiences, cultural differences from the U.S., unexpected parenting moments, and tips for families living in or visiting Japan. Curious about family life abroad or considering a trip to Japan with the munchkins? This episode is packed with helpful insight just for you!------ About the Krewe ------The Krewe of Japan Podcast is a weekly episodic podcast sponsored by the Japan Society of New Orleans. Check them out every Friday afternoon around noon CST on Apple, Google, Spotify, Amazon, Stitcher, or wherever you get your podcasts.  Want to share your experiences with the Krewe? Or perhaps you have ideas for episodes, feedback, comments, or questions? Let the Krewe know by e-mail at kreweofjapanpodcast@gmail.com or on social media (Twitter: @kreweofjapan, Instagram: @kreweofjapanpodcast, Facebook: Krewe of Japan Podcast Page, TikTok: @kreweofjapanpodcast, LinkedIn: Krewe of Japan LinkedIn Page, Blue Sky Social: @kreweofjapan.bsky.social, & the Krewe of Japan Youtube Channel). Until next time, enjoy!------ Support the Krewe! Offer Links for Affiliates ------Use the referral links below!Zencastr Offer Link - Use my special link to save 30% off your 1st month of any Zencastr paid plan! ------ Links for Tobias Harris ------Loretta on InstagramKemushiChan YouTube Channel------ Past Language Learning Episodes ------Inside Japanese Language Schools ft. Langston Hill (S6E3)Japanese Self-Study Strategies ft. Walden Perry (S5E4)Learn the Kansai Dialect ft. Tyson of Nihongo Hongo (S4E14)Heisig Method ft. Dr. James Heisig (S4E5)Prepping for the JLPT ft. Loretta of KemushiCan (S3E16)Language Through Video Games ft. Matt of Game Gengo (S3E4)Pitch Accent (Part 2) ft. Dogen (S2E15)Pitch Accent (Part 1) ft. Dogen (S2E14)Language through Literature ft. Daniel Morales (S2E8)Immersion Learning ft. MattvsJapan (S1E10)Japanese Language Journeys ft. Saeko-Sensei (S1E4)------ JSNO Upcoming Events ------JSNO Event CalendarJoin JSNO Today!

A simple universal TV remote app is making over $300,000/month — with almost no features and a basic paywall

Today on the show: ASO rejects Ralph Denk's sausage mountain feifdom, Israel-Premier Tech goes dark, and we were very e-xcited by the e-cycling e-world e-championships!

Japan's political scene is changing—from new parties rising in visibility to historic moments in national leadership—so the Krewe is bringing you a timely crash course. Political analyst Tobias Harris (Founder & Principal of Japan Foresight) joins the pod to break down the foundations of Japan's government system, how it compares to the U.S., and why voters view politics the way they do. We explore the major and emerging parties shaping the landscape, the issues driving debate today, and how international pressures and global events influence domestic policy. Tobias also sheds light on the media's role in shaping public perception and political accountability.------ About the Krewe ------The Krewe of Japan Podcast is a weekly episodic podcast sponsored by the Japan Society of New Orleans. Check them out every Friday afternoon around noon CST on Apple, Google, Spotify, Amazon, Stitcher, or wherever you get your podcasts.  Want to share your experiences with the Krewe? Or perhaps you have ideas for episodes, feedback, comments, or questions? Let the Krewe know by e-mail at kreweofjapanpodcast@gmail.com or on social media (Twitter: @kreweofjapan, Instagram: @kreweofjapanpodcast, Facebook: Krewe of Japan Podcast Page, TikTok: @kreweofjapanpodcast, LinkedIn: Krewe of Japan LinkedIn Page, Blue Sky Social: @kreweofjapan.bsky.social, & the Krewe of Japan Youtube Channel). Until next time, enjoy!------ Support the Krewe! Offer Links for Affiliates ------Use the referral links below!Zencastr Offer Link - Use my special link to save 30% off your 1st month of any Zencastr paid plan! ------ Links for Tobias Harris ------Japan ForesightObserving Japan on SubstackThe Iconoclast on AmazonTobias Harris on BlueSky------ Past History/Society Episodes ------The Castles of Japan ft. William de Lange S5E19)Foreign-Born Samurai: William Adams ft. Nathan Ledbetter (Guest Host, Dr. Samantha Perez) (S5E17)Foreign-Born Samurai: Yasuke ft. Nathan Ledbetter (Guest Host, Dr. Samantha Perez) (S5E16)Change in Urban & Rural Japanese Communities ft. Azby Brown (S5E15)Inside Japanese Homes & Architecture ft. Azby Brown (S5E6)Kendo: The Way of the Sword ft. Alexander Bennett, 7th Dan in Kendo (S4E16)Jokichi Takamine: The Earliest Bridge Between New Orleans & Japan ft. Stephen Lyman (S4E13)The Chrysanthemum Throne ft. Dr. Hiromu Nagahara [Part 2] (S2E18)The Chrysanthemum Throne ft. Dr. Hiromu Nagahara [Part 1] (S2E17)The Age of Lady Samurai ft. Tomoko Kitagawa (S1E12)------ JSNO Upcoming Events ------JSNO Event CalendarJoin JSNO Today!

Na atoa i le Aso Lua o le vaiaso, le Aso 11 o Novema, le 50 tausaga talu ona fa'ate'aina fa'amalosi le faigamalo a le Labor na ta'ita'ia e le palemia Gough Whitlam.

Atlanta's congressional delegation unlikely to vote for GOP funding plan to reopen the government; Atlanta's public defender's office prepares for doubling of its caseload; and Lois Reitzes speaks with ASO's Norman Mackenzie about what makes Beethoven's Ninth, returning to Atlanta Symphony Hall this week, the enduring work it is. See omnystudio.com/listener for privacy information.

What happens when your app already converts well, but you've hit the ceiling with ASO and ASA?In this live coaching session, Steve P. Young coaches the founder of Scribbe AI, an AI-powered note-taking app, to uncover the next steps for scaling growth beyond traditional app marketing tactics.We'll dive deep into how to find new, scalable channels for user acquisition systematically, explore what separates top-performing apps from the rest, and discuss strategies that actually deliver results when paid ads and influencer campaigns fall short.You'll see real questions, real strategies, and actionable takeaways you can immediately apply to your own app growth journey.You will discover:✅ What to prioritize after ASO and ASA✅ When Meta ads actually make sense✅ How to test and find viral formats that work✅ Community-led growth via Reddit and niche forums✅ Hidden wins from non-US markets most founders ignoreLearn More:Scribbe: AI Notes Takerhttps://apps.apple.com/us/app/scribbe-ai-notes-taker/id6736370215 Connect with Neil:https://www.linkedin.com/in/neil-saduka/Work with us:https://appmasters.com/ You can also watch this video here: https://www.youtube.com/live/5GvJprsRLjsGet training, coaching, and community: ⁠https://appmastersacademy.com/*********************************************SPONSORSArcads is the fastest and best indie-friendly platform to create authentic, AI-powered UGC-style video ads — all from just text input.- Emotionally resonant, human-like videos- Perfect for app demos, testimonials, and paid social creatives- Built for speed, built to convertWhether you're launching or scaling, Arcads makes it easy to test and iterate video ads.Try it now: ⁠https://www.arcads.ai/?comet_custom=appmasters*********************************************

This episode is about seasonal affective disorder, hunger, and wanting more than you can handle currently. We also revisit the conversation with my inner bimbo from the last episode."And You Will Feel Sun On Your Face", "Seasonal Affective Chides Its Host", "November Has Come", and "Iowanna", all original poems read by me. Clips in this episode from the following songs are used under creative commons:"Euphoria" by Kendrick Lamar."HappyHappy's ASMR Hour" by HappyHappy"November Has Come" by the GorillazSongs fully used in this episode are all by Jaxius, save for the last one at the end, which is 'Teakwood', by Aso.

Ever wondered how some apps skyrocket up the charts while you're still stuck optimizing screenshots?

This week on the GCN Show, we dive into the weird world of predetermined races—should fixed post-Tour criteriums be banished to the history books, or are they a bit of fun that should be celebrated? We discuss the origins of these races, share our own experiences, and debate the end-of-season ASO-run criteriums in Singapore and Japan. Plus, we've got a new law in Canada that could make it illegal to drop your child off to school on a bike, a new massive gravel stage race, and Conor tries to sell Dan on the UK's first "boozy bike trail".

Would you like access to our advanced agency training for FREE? https://www.agencymastery360.com/training How would you go about making acquisitions to accelerate your growth? Would you buy for revenue, culture fit, or client roster? Would you be willing to fire big clients that are holding your agency back? Most agency owners chase growth by saying "yes" to everything, from new services, new clients, and every new opportunity. Today's featured guest built one of the fastest-growing mobile and digital agencies in the world by narrow focusing, firing bad-fit clients, and mastering the art of strategic acquisitions. Today he'll unpack how his agency evolved from a small mobile startup in Tel Aviv to a global digital powerhouse working with brands like Google, Uber, Samsung, and Microsoft. Gilad Bechar is the CEO and founder of Moburst, a mobile-first marketing and digital transformation agency with offices in Tel Aviv, New York, and San Francisco. Since 2013, Moburst has helped startups and Fortune 500s alike scale their reach through creative, data-driven, and tech-forward strategies. Under Gilad's leadership, the agency has raised capital, acquired multiple specialized firms, and built proprietary technology that keeps them ahead of the curve in AI, mobile UX, and cross-platform performance. In this episode, we'll discuss: The similarities between the mobile boom and the new AI era. Raising capital without losing control. Using acquisitions as a growth strategy. The power of saying no and focusing on fit. Subscribe Apple | Spotify | iHeart Radio Sponsors and Resources This episode is brought to you by Wix Studio: If you're leveling up your team and your client experience, your site builder should keep up too. That's why successful agencies use Wix Studio — built to adapt the way your agency does: AI-powered site mapping, responsive design, flexible workflows, and scalable CMS tools so you spend less on plugins and more on growth. Ready to design faster and smarter? Go to wix.com/studio to get started. From A Mobile-First Niche Focus to Global Agency Powerhouse When Moburst launched in 2013, the agency world was flooded with "digital experts" who claimed to understand mobile. Most didn't. Gilad noticed that agencies were simply repurposing desktop experiences for smaller screens without real mobile UX thinking, no data-driven optimization, and definitely no understanding of how users behaved differently on apps. That insight became Moburst's edge. Instead of trying to compete as another full-service digital shop, they doubled down on mobile-first marketing. They mastered app store optimization (ASO), performance tracking, and mobile UX design. That focus helped them land early wins with major clients who were desperate for expertise in a fast-changing environment. As Gilad puts it, "When you show big clients that a critical piece of their marketing is being ignored, and you can fix it, that's your entry point." The AI Parallel: Most Agencies Talk, Few Deliver Gilad sees history repeating itself with AI. Just like the early mobile days, everyone's suddenly an "AI expert." But the difference between hype and real expertise shows up fast in a conversation. He believes the proof lies under the hood. Real experts can answer deep implementation questions: which tools integrate best, how to handle data security, and what AI models perform for specific tasks. Pretenders can't. For agencies, this is a reminder that credibility is earned through insight, not jargon. Clients see through the buzzwords. And the ones who don't will eventually learn when the work doesn't deliver. Raising Capital Without Losing Control Unlike most agency founders, Gilad took venture funding, not once, but three times. But he did it differently. Instead of giving away huge equity chunks, Moburst only diluted small percentages (around 6% each round). The investors came to them after seeing how fast their clients were growing. Without that, his agency wouldn't have its current success in the US market and would probably still be a very local agency in Israel. That capital gave him the means to hire a team in New York and then eventually move there to lead that office. It was the start of many new opportunities for the agency, like building internal tech tools that set them apart. It was also the way his team has stayed ahead of the curve from competitors that are not investing in the future and stay too focused on the right here and now. Furthermore, despite having 11 investors, Moburst kept full control. Only one board seat represents all investors, and it can't override the founders' decisions. According to Gilad, that control is what allowed them to make hard but smart moves, like firing clients and cutting costs in 2017 when growth was strong but profitability wasn't. The Hard Reset That Saved the Agency and Restored Profitability In 2017, Moburst was scaling fast but losing money just as quickly. The agency was adding clients and headcount, but without the right systems to manage profitability. At one point, they were bleeding up to $70,000 a month. So Gilad made the tough call: he cut unprofitable clients, reduced staff, and rebuilt the agency around systems that supported healthy margins. "It was brutal," he admits. "We let go of big, well-known clients we loved working with. But it didn't make sense to keep losing money just to say we worked with them." That painful reset worked. By 2018, the agency was profitable again and positioned for sustainable growth. That reset set the stage for their next evolution: acquisitions. How to Use Acquisitions as a Growth Strategy (Not a Gamble) Moburst's acquisition strategy wasn't about buying revenue or chasing vanity growth. It was about buying capabilities that solved their biggest operational gaps. Their first acquisition was a video production studio they had already worked with for over a year. The partnership was strong, the culture aligned, and the collaboration was smooth. So they brought them in-house in 2019 and the agency's offerings instantly expanded. Then they looked at their next biggest outsourced expense: web and app development. So in 2022, they acquired a dev shop after a successful collaboration period. In total, Moburst has made five acquisitions, each one following a simple rule: test first, integrate later. As Gilad says, "We don't buy to solve problems. We buy what already works and multiply it." When asked about whether or not these brands keep their names after acquisition, Gilad says it all depends on their brand authority. If they do great work and have a solid team but their brand isn't as strong, then it's best to just bring it under the Moburst umbrella. In case they do have a strong brand, then they'll just make sure their website reflects they are part of a larger group. How to Structure an Agency Acquisition Deal the Smart Way For agency owners eyeing their own M&A moves, Gilad shared his preferred deal structure. Each acquisition has four key components: Cash upfront - Rewards founders for their hard work. Equity - Gives them a stake in the larger vision. Dividends - Paid yearly so they benefit from the agency's profits. Performance bonuses - Tied to the profitability of their specific business unit. This structure keeps founders motivated and aligned for years to come, without the traditional burnout that comes from rigid earnouts. Everyone wins when growth is sustainable and collaborative. Why Firing Bad Clients Helps Scale Smarter One of the biggest lessons Gilad takes away from journey is the courage to say no: to clients, deals, or directions that don't fit. Agencies often cling to bad accounts out of fear of losing revenue, but simply put, that's a silent killer. If you're not profitable on a client, you're not just breaking even; you're paying for the privilege of overworking your team. Moburst's growth didn't come from doing more — it came from doing what mattered most. By focusing, pruning, and strategically acquiring, Gilad turned a niche mobile startup into a global digital powerhouse. Do You Want to Transform Your Agency from a Liability to an Asset? Looking to dig deeper into your agency's potential? Check out our Agency Blueprint. Designed for agency owners like you, our Agency Blueprint helps you uncover growth opportunities, tackle obstacles, and craft a customized blueprint for your agency's success.

Huntington's disease is a rare, inherited neurodegenerative disorder caused by a type of genetic mutation known as a trinucleotide repeat expansion, which leads to the production of a toxic protein that causes progressive brain cell loss. Vico Therapeutics is developing an experimental antisense oligonucleotide to treat the condition. Because the therapy targets the repeat expansion itself, rather than a specific gene, it may have applications across a broader set of so-called polyglutamine diseases of which Huntington's is one. We spoke to Prarthana Khanna, vice president of corporate business development and strategy for Vico, about Huntington's disease, the company's experimental ASO to target the disease, and why it has the potential to address multiple neurological diseases.

This week, we take a detour from chatting about the 2025 season to talk next summer. The ASO unveiled the route for the 2026 Tour de France Femmes avec Zwift last Thursday, and it has everything. Iconic climbs, a legit time trial, plenty of opportunities for the opportunists, and a leg-breaking circuit race to end the nine-stage week. One thing missing? Sprint stages. Abby sits down with Kate Veronneau to talk about next year's Tour, what they are excited about (everything), and Zwift's decision to continue sponsorship of the race for four more years.

I lana malelega i le fa'ailogaina o le Aso o Taumafa i le Lalolagi (World Food Day), na saunoa ai le Tupu Sa o le Ekalesia Katoliko Roma, Pope Leo, i le tulaga ua mafatia ai nisi o tagata ona o le matape'ape'a o isi i le lalolagi.

One of FourIn my so-called career, I've known four geniuses: one evil, one chaos made flesh, and two nice; Dan is in the last group.There are many theories around what makes someone a genius; I define it as the ability to make connections where others cannot see them. Dan is professionally (at least in EPMland) best known for his deconstruction of ASO Essbase, understanding its architecture and fundamentals, and how to optimise it.If you were in his "Essbase ASO Performance:  When NOT to Depend on MDX" session at Kscope 2010, you know just what I'm talking aboutI was sort of slack jawed by the end of the presentation. How on earth did he figure this out? BSO Essbase's architecture was (and is) fully documented. Thank Arbor Software. The same was (and still is) not true for ASO Essbase. Thank (or don't) Hyperion Solutions.Dan took apart ASO Essbase, hypothesising, testing, rejecting, confirming, and simply intellectually beating the product halfway to death to mirror Codd's 12 rules for OLAP. His work revolutionized (and made my life considerably easier amongst many others) ASO Essbase theory and practice.If you weren't there and you practice Essbase, you probably have a copy of Developing Essbase Applications:  Advanced Techniques for Finance and IT Professionals.You can still (it came out in 2012!) buy it here on Amazon. One day Oracle will change the architecture behind ASO Essbase (maybe this has already happened – I'm out of that space now), but until then, and maybe even in future if they mimic the way ASO works/worked, Dan's chapter is the place to be.Listen to the podcast and hear how Dan did it and of course more back story of a fascinating man in an equally fascinating industry across time.Part 1 of 2In editing (and yes, I did it this time round and yes, I'm not very good at it as you'll hear glitches in the recording – sorry) an episode, there's always a temptation to cut content to fit an hour long format for brevity. However, EPM Conversations is about, well, conversations and if you were sitting in a coffee shop with Dan, you'd want to know a bit about his personal life – that's more in the second part although you'll get a good feel for him in this episode as well.Be seeing you.

Ua fa'asa'olotoina uma tagata Iutaia na 'ave fa'apagotaina e Hamas i le Aso 7 o Oketopa 2023.

ICP-2 lays out the criteria for the recognition of new RIRs. But what about the rest of the lifecycle of the organisations that coordinate the allocation and public registration of unique IP numbers? In this episode, Andrei Robachevsky of the NRO NC talks about the ICP-2 review.In November 2023, the NRO EC requested that the ASO AC "review and consider improvements to ICP-2". The NRO NC (in its role as ASO AC - see notes on organisations and acronyms below) thereby began a comprehensive review of the original document and put together a process for the creation of an updated ICP-2 through open consultation with the community. Having reached step seven in that process, the NRO NC is now receiving community feedback on version 2 of the draft RIR Governance Document (until 7 November 2025). The entire ICP-2 review process has been documented in detail in the ICP-2 section over on the NRO NC website. A note on organisations and acronymsICP-2: 'Internet Coordination Policy 2: Criteria for Establishment of New Regional Internet Registries' - document published and accepted by the ICANN Board of Directors in 2001.RIRs: The Regional Internet Registries; who coordinate the allocation and public registration of unique IP addresses and AS numbers for their service regions:RIPE NCC: Réseaux IP Européens Network Coordination Centre (est. 1992)APNIC: Asia Pacific Network Information Centre (est. 1993)ARIN: American Registry for Internet Numbers (est. 1997)LACNIC: Latin American and Caribbean Internet Addresses Registry (est. 2002)AFRINIC: African Network Information Centre (est. 2004)ICANN (est. 1998): The Internet Corporation for Assigned Names and Numbers; oversees the global allocation of domain names and unique Internet numbers; delegates these resources to the RIRs in its IANA function.IANA: The Internet Assigned Numbers Authority; originally Jon Postel; now a function carried out by ICANN.NRO: The Number Resource Organisation; coordinating body for the five RIRs.NRO EC: The NRO Executive Council; executive body for the NRO; composed of five members, one from each RIR.NRO NC: The NRO Number Council; fills the role of ASO AC for ICANN; composed of fifteen members, three from each RIR community.ASO: The Address Supporting Organisation; advises the ICANN Board on global IP address policies.ASO AC: The ASO Address Council; role within ICANN's ASO to ensure the proper implementation of global policy development process across the RIR regions; filled by the NRO NC. Hosted on Acast. See acast.com/privacy for more information.

Ua atoa tonu i le asō, Aso 7 o Oketopa, le 2 tausaga talu ona faia le osofa'iga a Hamas i Isara'elu lea na maliliu ai tagata e lata i le 1,200 ma ‘ave fa'apagotaina ai tagata Iutaia e to'a 250.

Na fa'amanatu i le vaiaso nei (Aso 30 Setema) le Aso Fa'avaomalo mo le Galuega Fa'aliliu ma Fa'amatala 'upu i le lalolagi le UN International Translation Day.

Want to go viral without having to create content?In this case study, we'll show you what we did to drive 100K downloads TWICE in 3 months. And how we took an indie app from zero traction to $4,000 in sales in just 2 months?

What if you had experiences that you couldn't explain? Our guest for this episode, Mitch, shares her unexplainable experiences and her personal confusion with the paranormal nature of these experiences.Mitch, thank you ulit sa pag share. Gaya nga ng sabi ko, kung ma explain nyo yung Aso sa Ospital, yung dumadalaw sa panaginip, message nyo lang ako at i relay ko yan kay Mitch.Kung ikaw rin ay nalilito sa mga experience mo at gusto mo is share yan, pwede mo yan email sa paranormalsph@gmail.comIf this is the first episode of the podcast you are listening to, I suggest you start at Episode 1:EPISODE 1 The Unexpected Visitor -https://youtu.be/AHSHtHOsNP0 Or if you prefer to share your stories through chat, you can share it on the Discord Server of Para Normal Podcast, to join just click on the invite link below: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://discord.gg/YWF4BpS4gQ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Eto yung episode ng Mysterious Universe na nasabi ko sa LL portion: https://www.youtube.com/watch?v=OflxfzsbRVsIf you enjoy this kind of conversation, you might want to subscribe :D ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Facebook⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Spotify⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠YouTube⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Tiktok⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Apple Podcast⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠- - - - - - - - - - - - - - - - - - Do you want to support the podcast? You can help keep us going by giving us a cup of joe! ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ko-fi.com/paranormalpodcast ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠You can also support us on Patreon ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://www.patreon.com/paranormalpodcast⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ We have different tiers for supporters, from the general support to early access, to joining us on the calls way in advance. No pressure, just additional help for us :) The Para Normal Podcast. Engineered and Produced by f90 Productions For brand partnerships, advertisements, or other collaboration opportunities with our podcast, please contact our management team at info@tagm.comRate and Review our show on Spotify, Pocket Casts, and Apple PodcastsEnjoy. 

Welcome to ROADSIDE presented by Zwift!    In today's episode, Tom and Jet unpack what was one of the most dramatic Vuelta España's we've ever seen, for all the wrong reasons. ASO proved they cannot guarantee the riders safety, Vingegaard delivered a clinical GC performance and has Pidcock's first GT podium lit the fuse for a big 2026?   Zwift Mailbag: Send in your questions, hypotheticals, takes and everything in between to thepressroompodcast@gmail.com and we will read the best ones out in the next episode!   -  -    The Roadside Cycling Show is presented by Zwift   Need a trainer? Try the all-new Zwift Ride - zwiftinc.sjv.io/55gL11 Head to https://www.zwift.com/ to start your free 14-day trial today. The Roadside Cycling Show is also supported by FE Sports, the home of premier cycling brands and products such as Wahoo, Pirelli, 100%, Campagnolo and more. Check out their range now - https://www.fesports.com.au/Shop/c_230/Products  Roadside's Tour de France coverage is brought to you by Quadlock! Use Roadside10 for 10% off Quadlock products and listen to our episodes for your chance to win a $200 voucher! https://www.quadlockcase.com.au/

Ataxia is a neurologic symptom that refers to incoordination of voluntary movement, typically causing gait dysfunction and imbalance. Genetic testing and counseling can be used to identify the type of ataxia and to assess the risk for unaffected family members. In this episode, Katie Grouse, MD, FAAN, speaks with Theresa A. Zesiewicz, MD, FAAN, author of the article “Ataxia” in the Continuum® August 2025 Movement Disorders issue. Dr. Grouse is a Continuum® Audio interviewer and a clinical assistant professor at the University of California San Francisco in San Francisco, California. Dr. Zesiewicz is a professor of neurology and director at the University of South Florida Ataxia Research Center, and the medical director at the University of South Florida Movement Disorders Neuromodulation Center at the University of South Florida and at the James A. Haley Veteran's Hospital in Tampa, Florida. Additional Resources Read the article: Ataxia Subscribe to Continuum®: shop.lww.com/Continuum Earn CME (available only to AAN members): continpub.com/AudioCME Continuum® Aloud (verbatim audio-book style recordings of articles available only to Continuum® subscribers): continpub.com/Aloud More about the American Academy of Neurology: aan.com Social Media facebook.com/continuumcme @ContinuumAAN Full episode transcript available here Dr Jones: This is Dr Lyell Jones, Editor-in-Chief of Continuum. Thank you for listening to Continuum Audio. Be sure to visit the links in the episode notes for information about earning CME, subscribing to the journal, and exclusive access to interviews not featured on the podcast. Dr Grouse: This is Dr Katie Grouse. Today I'm interviewing Dr Theresa Zesiewicz about her article on ataxia, which appears in the August 2025 Continuum issue on movement disorders. Welcome to the podcast, and please introduce yourself to our audience.  Dr Zesiewicz: Well, thank you, Dr Grouse. I'm Dr Theresa Zesiewicz, otherwise known as Dr Z, and I'm happy to be here. Dr Grouse: I have to say, I really enjoyed reading your article. It was a really great refresher for myself as a general neurologist on the topic of ataxia and a really great reminder on a great framework to approach diagnosis and management. But I wanted to start off by asking what you feel is the key message that you hope our listeners will take away from reading your article. Dr Zesiewicz: Yes, so, thanks. I think one of the key messages is that there has been an explosion and renaissance of genetic testing in the past 10 years that has really revolutionized the field of ataxia and has made diagnosis easier for us, more manageable, and hopefully will lead to treatments in the future. So, I think that's a major step forward for our field in terms of genetic techniques over the last 10 years, and even over the last 30 years. There's just been so many diseases that have been identified genetically. So, I think that's a really important take-home message. The other take-home message is that the first drug to treat Friedreich's ataxia, called omaveloxolone, came about about two years ago. This was also a really landmark discovery. As you know, a lot of these ataxias are very difficult to treat. Dr Grouse: Now pivoting back to thinking about the approach to diagnosis of ataxia, how does the timeline of the onset of ataxia symptoms inform your approach? Dr Zesiewicz: The timeline is important because ataxia can be acute, subacute or chronic in nature. And the timeline is important because, if it's acute, it may mean that the ataxia took place over seconds to hours. This may mean a toxic problem or a hypoxic problem. Whereas a chronic ataxia can occur over many years, and that can inform more of a neurodegenerative or more of a genetic etiology. So, taking a very detailed history on the patient is very important. Sometimes I ask them, what is the last time you remember that you walked normal? And that can be a wedding, that can be a graduation. Just some timeline, some point, that the patient actually walked correctly before they remember having to hold onto a railing or taking extra steps to make sure that they didn't fall down, that they didn't have imbalance. That sometimes that's a good way to ask the patient when is the last time they had a problem. And they can help you to try to figure out how long these symptoms have been going on. Dr Grouse: I really appreciate that advice. I will say that I agree, it can sometimes be really hard to get patients to really think back to when they really started to notice something was different. So, I like the idea of referencing back to a big event that may be more memorable to them. Now, given that framework of, you know, thinking through the timeline, could you walk us through your approach to the evaluation of a patient who presents to your clinic with that balance difficulties once you've established that? Dr Zesiewicz: Sure. So, the first thing is to determine whether the patient truly has ataxia. So, do they have imbalance? Do they have a wide base gait? That's very important because patients come in frequently to your clinic and they'll have balance problems, but they can have knee issues or hip issues, neuropathy, something like that. And sometimes what we say to the residents and the students is, usually ataxia or cerebellar symptoms go together with other problems, like ocular problems are really common in cerebellar syndromes. Or dysmetria, pass pointing, speech disorder like dysarthria. So, not only do you need to look at the gait, but you should look at the other symptoms surrounding the gait to see if you think that the patient actually has a cerebellar syndrome. Or do they have something like a vestibular ataxia which would have more vertigo? Or do they have a sensory ataxia, which would occur if a person closes his eyes or has more ataxia when he or she is in the dark? So, you have to think about what you're looking at is the cerebellar syndrome. And then once we look to see if the patient truly has a cerebellar syndrome, then we look at the age, we look at---as you said before, the timeline. Is this acute, subacute, or chronic? And usually I think of ataxia as falling into three categories. It's either acquired, it's either hereditary, or it's neurodegenerative. It can be hereditary. And if it's not hereditary, is it acquired, or is it something like a multiple system atrophy or a parkinsonism or something like that? So, we try to put that together and start to narrow down on the diagnosis, thinking about those parameters. Dr Grouse: That's really a helpful way to think through it. And it is true, it can get very complex when patients come in with balance difficulties. There's so many things you need to think about, but that is a great way to think about it. Of course, we know that most people who come in to the Movements Disorders clinic are getting MRI scans of their brains. But I'm curious, in which cases of patients with cerebellar ataxia do you find the MRI to be particularly helpful in the diagnosis? Dr Zesiewicz: So, an MRI can be very important. Not always, but- so, something like multiple system atrophy type C where you may see a hot cross bun sign or a pontine hyperintensity on the T2-weighted image, that would be helpful. But of course, that doesn't make the diagnosis. It's something that may help you with the diagnosis. In FXTAS, which is fragile X tremor/ataxia syndrome, the patient may have the middle cerebellar peduncle sign or the symmetric hyperintensity in the middle cerebellar peduncles, which is often visible but not always. Something like Wernicke's, where you see an abnormality of the mammillary bodies. Wilson's disease, which is quite rare, T2-weighted image may show hyperintensities in the putamen in something like Wilson's disease. Those are the main MRI abnormalities, I think, with ataxia. And then we look at the cerebellum itself. I mean, that seems self-evident, but if you look at a sagittal section of the MRI and you see just a really significant atrophy of the cerebellum, that's going to help you determine whether you really have a cerebellar syndrome. Dr Grouse: That's really encouraging to hear a good message for all of us who sometimes feel like maybe we're missing something. It's good to know that information can always come up down the line to make things more clear. Your article does a great review of spinal cerebellar ataxia, but I found it interesting learning about the more recently described syndrome of SCA 27B. Would you mind telling us more about that and other really common forms of SCA that's good to keep in mind? Dr Zesiewicz: Sure. So, there are now 49 types of spinal cerebellar ataxia that have been identified. The most common are the polyglutamine repeat diseases: so, spinocerebellar ataxia type 3 or type 2, type 6, are probably the most common. One of the most recent spinocerebellar ataxias to be genetically identified and clinically identified is spinocerebellar ataxia 27B. This is caused by a GAA expansion repeat in the first intron of the fibroblast growth factor on chromosome 13. And the symptoms do include ataxia, eye problems, downbeat nystagmus, other nystagmus, vertical, and diplopia. It appears to be a more common form of adult-onset ataxia, and probably more common than was originally thought. It may account for a substantial number of ataxias, like, a substantial percentage of ataxias that we didn't know about. So, this was really a amazing discovery on SCA 27B. Dr Grouse: Now a lot of us I think feel a little anxious when we think about genetic testing for ataxia simply because there's so many forms, things are changing quickly. Do you have a rule of thumb or a kind of a framework that we can think of as we approach how we should be thinking about getting genetic testing for the subset of patients? Dr Zesiewicz: Sure. And I think that this is where age comes into play a lot. So, if you have a child who's 10, 11, or 12 who's having balance problems in the schoolyard, does not have a history of ataxia in the family, the teachers are telling you that the child is not running correctly, they're having problems with physical education, that is someone who you would think about testing for Friedreich's ataxia. A preteen or a child, that would be one thing that would be important to test. When you talk to your patient, it's important to really take a detailed family history. Not just mom or dad, but ethnicity, grandparents, etc. And sometimes, once in a while, you come up with a known spinal cerebellar ataxia. Then you can just test for that. So, if a person is from Portugal or has Portugal background and they have ataxia and the parents had ataxia, you would think of spinal cerebellar ataxia type 3. Or if they're Brazilian, or if the person is from a certain area of Cuba and mom and dad had ataxia and that person has ataxia, you would think of spinal cerebellar ataxia type 2. Or if a person has ataxia and their parent had blindness or visual problems, you may be more likely to think of spinal cerebellar ataxia type 7, for example. If they have that---either they have a known genetic cause in in the family, first degree family, or they come from an area of the world in which we can pinpoint what type we think it is---you can go ahead and get those tests. If not, you can take an ataxia comprehensive panel. Many times now, if you take the panel and the panel is negative, it will reflex to the whole exome gene sequencing, where we're finding really unusual and more rare types of ataxia, which are very interesting. Spinal cerebellar ataxia type 32, spinal cerebellar ataxia type 36, I had a spinal cerebellar ataxia type 15. So, I think you should start with the age, then the family history, then where the person is from. And then, if none of those work out, you can get a comprehensive panel, and then go on to whole exome gene sequencing. Dr Grouse: That's really, really useful. Thank you so much for breaking that down in a really simple way that a lot of us can take with us. Pivoting a little bit now back towards different types of acquired ataxias, what are some typical lab tests that you recommend for that type of workup? Dr Zesiewicz: Again, if there's no genetic history and the person does not appear to have a neurodegenerative disease, we do test for acquired ataxias. Acquired ataxias can be complex. Many times, they are in the autoimmune family. So, what we start with are just basic labs like a CBC or a CMP, but then we tried to look at some of the other abnormalities that could cause ataxia. So, celiac disease, stiff person syndrome. So, you would look at anti-glutamic acid decarboxylase antibodies, Hashimoto's---so, antithyroglobulin antibodies or antithyroperoxidase antibodies would be helpful. You know, in a case of where the patients may have an underlying neoplasm, maybe even a paraneoplastic workup, such as an anti-Hu, anti-Yo, anti-Ri. A person has breast cancer, for example, you may want to take a paraneoplastic panel. I've been getting more of the anti-autoimmune encephalitis panels in some cases, that were- that are very interesting. And then, you know, things that sometimes we forget now like the syphilis test, thyroid-stimulating test, take a B12 and folate, for example. That would be important. Those are some of the labs. We just have on our electronic chart a group of acquired labs for ataxia. If we can't find any other reason, we just go ahead and try to get those. Dr Grouse: Now, I'm curious what you think is the most challenging aspect of diagnosing a patient with cerebellar ataxia? Dr Zesiewicz: So, for those of us who see many of these patients a day, some of the hardest patients are the ones that---regardless of the workup that we do, we've narrowed it down, it's not hereditary. You know, they've been through the whole exome gene sequencing and we've done the acquired ataxia workup. It doesn't appear to be that. And then we've looked for parkinsonism and neurodegenerative diseases, and it doesn't appear to be that either; like, the alpha-synuclein will be negative. Those are the toughest patients, where we think we've done everything and we still don't have the answer. So, I've had patients in whom I've taken care of family members years and years ago, they had a presumed diagnosis, and later on I've seen their children or other family members. And with the advent of the genetic tests that we have, like whole exome gene sequencing, we have now been able to give the patient and the family a definitive diagnosis that they didn't have 25 years ago. So, I would say don't give up hope. Retesting is important, and as science continues and we get more information and we make more landmark discoveries in genetics, you may be better able to diagnose the patient. Dr Grouse: I was wondering if you had any recommendations regarding either some tips and tricks, some pearls of wisdom you can impart to us regarding the work of ataxia, or conversely, any big pitfalls that you can help us avoid? I would love to hear about it. Dr Zesiewicz: Yeah, there's no easy way to treat or diagnose ataxia patients. I've always felt that the more patients you see- and sounds easy, but the more patients you see, the better you're going to become at it, and eventually things are going to fall into place. You'll begin to see similarities in patients, etc. I think it's important not only to make sure that a person has ataxia, but again, look at the other signs and symptoms that may point to ataxia that you'll see in a cerebellar syndrome. I think it's important to do a full neuroexam. If a person has spasticity, that may point you more towards a certain type of ataxia than if a person has no reflexes, for example, that we see in Friedreich's ataxia. Some of the ocular findings are very interesting as well. It's important to know if a person has a tremor. I've seen several Wilson's disease cases in my life with ataxia. They're very important. I think a full neuroexam and also a very detailed history would be very helpful. Dr Grouse: Tell us about some promising developments in the diagnosis and management of ataxia that we should be on the lookout for. Dr Zesiewicz: The first drug for Friedreich's ataxia was FDA-approved two years ago, which was an NRF2 activator, which was extremely exciting and promising. There are also several medications that are now in front of the FDA that may also be very promising and have gone through long clinical trials. There's a medication that's related to riluzole, which is a medication used for amyotrophic lateral sclerosis, that has been through about seven years of testing. That is before the FDA as well for spinal cerebellar ataxia. Friedreich's ataxia has now completed the first cardiac gene therapy program with AAV vectors, which- we're waiting for full results, but that's a cardiac test. But I would assume that in the future, neurological gene therapy is not far behind if we've already done cardiac gene therapy and Friedreich's ataxia. So, you know, some of these AAV vector-based genetic therapies may be very helpful, as well as ASO, antisense oligonucleotides, for example. And I think in the future, other things to think about are the CRISPR/Cas9 technology for potential treatment of ataxia. It is a very exciting time, and some major promising therapies have been realized in the past 2 to 3 years. Dr Grouse: Well, that's really exciting, and we'll all look forward to seeing these becoming more clinically applicable in the future. So, thank you so much for coming to talk with us today. Dr Zesiewicz: Thank you. Dr Grouse: Again, today I've been interviewing Dr Theresa Zesiewicz about her article on ataxia, which appears in the August 2025 Continuum issue on movement disorders. Be sure to check out Continuum Audio episodes from this and other issues, and thank you to our listeners for joining today. Dr Monteith: This is Dr Teshamae Monteith, Associate Editor of Continuum Audio. If you've enjoyed this episode, you'll love the journal, which is full of in-depth and clinically relevant information important for neurology practitioners. Use the link in the episode notes to learn more and subscribe. AAN members, you can get CME for listening to this interview by completing the evaluation at continpub.com/audioCME. Thank you for listening to Continuum Audio.

✦ Atlanta Symphony Orchestra will perform a special one-night-only concert on Friday, September 19, and everything on the program is special. Superstar pianist Lang Lang will be the soloist for Beethoven's Majestic Emperor Concerto, and the internationally acclaimed conductor Gemma New will direct the ASO in two works by Mozart. WABE icon and City Lights Collective member Lois Reitzes recently spoke with New to discuss the exhilarating beauty of Beethoven's and Mozart's work. ✦ City Lights Collective member Shane Harrison spends his days at Arts ATL looking for cultural events to share with readers. He joins us weekly to share highlights, and today his mix includes the world premiere of Atlanta playwright Topher Payne's latest comedy, and four upcoming performances from the Atlanta Ballet at the Cobb Energy Performing Arts Centre. ✦ Atlanta's catching its annual case of mural mania once again with the upcoming Forward Warrior Festival. The all-day creative celebration is this Saturday, September 13, in Cabbagetown. Each year, the walls of Wylie Street, right by the Krog Street Tunnel, are transformed with works of new art. Atlanta artist Peter Ferrari founded the festival, and when he spoke with City Lights Collective co-host Kim Drobes, he discussed both the history and the future of community-driven events. ✦ Visual artist and music enthusiast Kosmo Vinyl bought his first LP when he was nine. He spent the next several decades immersed in music and began his professional career at London's pioneering indie label, "Stiff Records." In 1979, Kosmo started working exclusively with "The Clash," who were once billed as The Only Band That Matters, and stayed by their side until the punk icons disbanded in 1986. Over the years, Kosmo's record collection became legendary. In 2014, he began posting about his favorite releases on social media for his series, "Kosmo's Vinyl of the Week," and he joins us weekly to share the stories behind the records he treasures. Today, he shares the story behind the New Miles Davis Quintet's version of "Just Squeeze Me." ✦ Robert Frost once urged us to "take the road less traveled." Atlanta photographer Geo Gerard chose a different path—riding his bike along every road within the I-285 perimeter. From 2020 to 2022, he documented the journey, capturing everyday moments of awe, joy, and humor. The result is "All the Roads Taken," a new exhibit on view at Gallery 100 through September 25. WABE arts reporter Summer Evans spoke with Gerard about the project. ✦ Have you ever been curious about the people running in groups along the sidewalk or on the sidewalk or along the beltline? Well, City Lights Collective member and WABE Studios intern Oli Turner decided to lace up her sneakers and catch up with some of Atlanta's many run clubs. See omnystudio.com/listener for privacy information.

Struggling to get app store reviews? Or maybe you've hit a wall with your average rating stuck at 4.2 or 4.3?

S&P Futures are displaying weakness this morning as markets react to the latest round of earnings. This morning, markets are awaiting a key inflation report as the PCE data is due out before the bell. The Trump Administration is looking to expand the tariffs on steel and aluminum products. Fed Gov Cook is schedule to have a hearing this morning on her employment at the Fed. Fed Gov Waller and continue to push for lower rates due to the expectations of a weakening labor market. BABA announced the development of a new AI chip that is more versatile than its older chips. Seeing strong gains in BABA, AFRM, ADSK, ESTC & ULTA after earnings releases. Monday is a holiday, on Tuesday morning, ASO & SIG are expected to release quarterly updates.

Right up front here, let me just state loudly that there are some amazing independent TPAs (third-party administrators) out there who have the expertise, the scrappy willfulness, and the deep desire to do right by their clients, their self-insured employer clients. For a full transcript of this episode, click here. If you enjoy this podcast, be sure to subscribe to the free weekly newsletter to be a member of the Relentless Tribe. And look, they may be facing some of the same headwinds that plan sponsors themselves face, like anticompetitive contracts, brokers who are up to no good, etc. So, just keep that in mind as you listen. And the main point of all of this if you are a plan sponsor is, find a good TPA partner, which, as Bryce Platt has said about consultants but same rules apply about TPAs here, the difficulty is being informed enough to tell the difference. So, the goal of this show is to help with that, the “be informed enough to tell the difference.” All of this being said, this is technically a Take Two; but we trimmed it down and welcome to a whole new intro. So, call this a refresher and an update about a really, really important topic from last year that is becoming extremely (maybe even more) relevant this year. Really relevant. Consider, for example, the show with Claire Brockbank (EP453) about carrier/TPA RFPs (requests for proposal) and all of the landmines that are really expensive, that are buried in some of these contracts. Then there was the Cynthia Fisher show (EP457) from last year about the millions, maybe billions of dollars in aggregate going missing in medical (ie, TPA or ASO [administrative services only]) spread pricing. We had “The Mystery of the Weekly Claims Wire” show with Justin Leader (EP433), again, revealing money that's being disappeared when the TPA is withdrawing dollars from plan sponsor checking accounts. And then there's the payment integrity episode with Kimberly Carleson (EP480) from a few weeks ago with just another wrinkle on this, namely TPAs or ASOs who insist on auditing themselves and how that turns out for members and plan sponsors. Oh, and last, but certainly not least, is the whistleblower show with Ann Lewandowski (EP476) on how a TPA arm of an EBC (employee benefit consultant) allegedly pocketed $20 million—$20 million of their client's pharma rebates—and used that $20 million to fund their executive bonus pool. What a time to be alive! All of this just highlights the huge stakes for plan sponsors to really understand what their TPA is all about. And when I say high stakes, I mean from both a legal standpoint and also just vast dollars in play here. But this episode with Elizabeth Mitchell is also, I'm gonna say, extremely relevant given just a few ripped from the headlines and news articles such as these. I'm gonna start actually with a post from Kimberly Carleson, and I like the comment by Jeff Evans, who wrote, “How does $8,710 equal $104,266?” Spoiler alert, it doesn't. Lots of missing dollars there. Someone's hands are in the cookie jar. Oh, look, the TPA has entered the chat. In a nutshell, and I'm quoting something Peter Hayes wrote, he wrote, “TPAs have received relatively little public attention. [There's an article in Health Affairs] that describes how TPAs impose hidden fees, benefit from their own form of spread pricing, and otherwise prioritize their own financial interests over those of their plan clients.” Also, here's a totally other issue. Let me quote Luke Prettol highlighting something Jason Shafrin had written about a paper by Jeff Marr, Daniel Polsky, and Mark Meiselbach. Let me slightly rephrase what Luke said. He wrote, “Employers pay, on average, a 4.7% [so almost 5%] price markup when hospitals are in their TPA's [Medicare Advantage] network.” Right? Dr. Eric Bricker talked about this in that episode (EP472) just how TPAs with MA (Medicare Advantage) business negotiate their commercial clients to pay higher rates so that then they can pay lower rates for their own MA members. As Luke wrote, “On its face, this overpayment does not appear to be solely in the interest of participants.” No kidding. Now, let's spin the wheel here. There are barriers for TPAs themselves, even the ones who have a deep desire to do the right thing. As Patrick Moore wrote, “Most TPAs still can't do [many of the things that employers might want because there are] PPO contracts.” So, is it a rock in a hard place situation? I mean, if the TPA has no other options than using a carrier's PPO (preferred provider organization) network with all its attendant contractual issues, then yeah, that is one definite challenge. Along these lines, let me read a post by Rina Tikia, because I think she sums up this really well. “When independent TPAs … push for transparency, they're blocked under the banner of ‘fiduciary risk.' “Meanwhile, the largest carriers and PBMs, with Cayman shell subsidiaries, DOJ kickback probes, [huge] hedge fund ties, [$10 million-plus] lobbying budgets, and antitrust violations continue unchecked. They are not only allowed to operate but celebrated as mainstream options. “Why the double standard? Political donations? Foundation smokescreens? Nonprofit status as a PR shield?” These are excellent questions. And here's another challenge: brokers. Ramesh Kumar Budhani wrote about this one, just how hard it is sometimes to find—for TPA, an independent TPA, trying to do the right thing—to find brokers who prioritize doing the right thing for employers and helping their clients save money. The summary of all of this: There are TPAs and there are ASOs who aren't even trying. They are going to ride the flywheel, the gravy train, and catch all of the dollars flying off of it for as long as they can manage to cling to it with all 10 of their fingers. Then there are TPAs, mostly indies, trying super hard to do the right thing. But how successful they are is going to depend on how boxed in they are by the PPO networks or the carriers that the brokers or even plan sponsors may insist on. Just how courageous they are and just how smart they are and experienced they are about the market and how it actually operates. So, the show that follows is about all of this, including how we can inspire TPAs, which, in the show that follows, subsumes ASOs kind of into it. But in the show that follows, I hope it's inspiring to create an environment so that the market demands TPAs that do all of the things, and we make inertia not a viable business strategy. Elizabeth Mitchell, my guest today, currently serves as the president and CEO of the Purchaser Business Group on Health. Also mentioned in this episode are Purchaser Business Group on Health; Bryce Platt; Claire Brockbank; Cynthia Fisher; Justin Leader; Kimberly Carleson; Ann Lewandowski; Jeff Evans; Peter Hayes; Luke Prettol; Jason Shafrin; Jeff Marr; Daniel Polsky; Mark Meiselbach; Eric Bricker, MD; Tom Nash; Patrick Moore; Rina Tikia; Ramesh Kumar Budhani; Mark Cuban; Harold Miller; Chris Deacon; Moby Parsons, MD; Benjamin Schwartz, MD, MBA; Mishe Health; Rik Renard; and Cora Opsahl. You can learn more at PBGH and by connecting with Elizabeth on LinkedIn.   Elizabeth Mitchell, president and CEO of the Purchaser Business Group on Health (PBGH), advances its strategic focus areas of advanced primary care, functional markets, and purchasing value. She leads PBGH in mobilizing health care purchasers, elevating the role and impact of primary care, and creating functional healthcare markets to support high-quality affordable care, achieving measurable impacts on outcomes and affordability. At PBGH, Elizabeth leverages her extensive experience in working with healthcare purchasers, providers, policymakers, and payers to improve healthcare quality and cost. She previously served as senior vice president for healthcare and community health transformation at Blue Shield of California, during which time she designed Blue Shield's strategy for transforming practice, payment, and community health. Elizabeth served as the president and CEO of the Network for Regional Healthcare Improvement (NRHI), a network of regional quality improvement and measurement organizations. She also served as CEO of Maine's business coalition on health (the Maine Health Management Coalition), worked within an integrated delivery system (MaineHealth), and was elected to the Maine State Legislature, serving as a State Representative. Elizabeth served as vice chairperson of the U.S. Department of Health and Human Services Physician-Focused Payment Model Technical Advisory Committee, board and executive committee member of the National Quality Forum (NQF), member of the National Academy of Medicine's “Vital Signs” Study Committee on core metrics, and a guiding committee member for the Health Care Payment Learning & Action Network. Elizabeth holds a degree in religion from Reed College and studied social policy at the London School of Economics.   08:06 What is the overarching context for health plans in healthcare purchasing? 11:31 Why is it important to reestablish a connection between the people paying for care and people providing care? 13:47 What are the needs of a self-insured employer when managing employee benefits? 19:00 Is it doable for employers to set their own contracts? 21:24 Is transparency presumed? 22:39 Will the new transparency upon us actually expose wasted expense? 24:23 EP408 with Chris Deacon. 25:58 “This is not about individual bad actors. … The systems … that is not aligned.” 27:39 Are there providers who want to work directly with employers? 30:53 Why is it important that incentives need to be aligned? 32:42 EP427 with Rik Renard. 33:51 What's missing from the conversation on changing health plans?   You can learn more at PBGH and by connecting with Elizabeth on LinkedIn.   @lizzymitch2 of @PBGHealth discusses #TPA and #healthplan vs. #jumboemployer inertia on our #healthcarepodcast. #healthcare #podcast #financialhealth #patientoutcomes #primarycare #digitalhealth #healthcareleadership #healthcaretransformation #healthcareinnovation   Recent past interviews: Click a guest's name for their latest RHV episode! Dave Chase, Jonathan Baran (Part 2), Jonathan Baran (Part 1), Jonathan Baran (Bonus Episode), Dr Stan Schwartz (Summer Shorts), Preston Alexander, Dr Tom X Lee (Take Two: EP445), Dr Tom X Lee (Bonus Episode), Dr Benjamin Schwartz, Dr John Lee (Take Two: EP438), Kimberly Carleson, Ann Lewandowski (Summer Shorts)  

Ua aumaia se fa'aaliga e le malo tausi ua ta'ua ai le toe tatalaina o a'oga i le atunu'u i le Aso 1 o Setema.

Okay, to review from Part 1 of this conversation, and if you didn't listen to it because you think you know how this whole skyrocketing healthcare costs thing works, let me tell you, I myself had a few revelations. So, go back and listen. For a full transcript of this episode, click here. If you enjoy this podcast, be sure to subscribe to the free weekly newsletter to be a member of the Relentless Tribe. But to be fair, if you didn't already, sure, fine. Listen to Part 2 here first and then do it backwards. It probably won't make that much difference, except you'll need to contend with me totally ruining the Part 1 suspense because here's the negative flywheel, starting with the axle. Employers and other plan sponsors have been convinced to buy discounts, including discounts or discounts by their other aliases: rebates and probably shared savings, too, I would throw in this category. This is the grease that keeps the flywheel spinning. What's the “why” there? It's a genius idea if you think about it. And if you're not fully understanding what I'm about to say, go back, for sure, and listen to Part 1 of this episode because this is a very fundamental concept that has come up over and over and over again on this podcast. Cora Opsahl (EP452) talked about it. Claire Brockbank (EP453); Eric Bricker, MD (EP472); Chris Crawford (EP465) for just four shows off the top of my head in the past, you know, eight months or so. Here's the concept: If you buy discounts, your costs will go up. Am I saying this theoretically? No, I'm not. Look at the last 20 years. Have costs gone up way higher than inflation? Yes, they have. What are we doing? We're buying discounts. So, it's hard to argue. Renewals every single year will just keep going up the longer that we buy discounts. We talk about this, Jonathan Baran and I, in Part 1, how carriers have created a really very self-serving buying framework where employers are trained to buy discounts. Discounts are the axle, and the buying of discounts becomes the top of our flywheel. And then some so inclined hospital system executives, there are certainly executives standing 10,000 feet from any bedside, so they really have zero idea how care or patients or even clinicians are impacted. But if plan sponsors buy discounts, those at health systems who are so inclined now have no real incentive to rein in prices or focus on appropriate care even. And if you are so inclined, if you're very margin focused as a healthcare executive, you know, first things first, go gut primary care. That is step one in every playbook, and we definitely talk about that in Part 1 of this episode. And also, again, in about 10 episodes from earlier this year. Another thing that you're gonna wanna do if your prime imperative is margin at a healthcare system is maximize the revenue off of every transaction. So, hey … hello, EHR systems. So now you have health system prices creeping up and up, unfettered, you know, just exacerbated by consolidation and a bunch of other different things. But you've got healthcare prices creeping up, you have volume the same or higher because we're not preventing chronic disease like you would with advanced primary care, for example. And now we're back at the “Oh wow, let me sell you another discount. And renewal is only 9% or whatever.” Thus, the flywheel spins. Alright, so let's turn this wheel around, shall we? Flip it 180. What's the fix? This is what Jonathan Baran talks about in the episode that follows, but he says, Hey, how about this? Instead of putting “get bigger discounts” in the middle of the flywheel, why don't we put “buy better member health”? That's a good start. Buy a health plan that delivers better member health at an affordable price. Buy the care, not buy a discount off of a price we can't see for net price we can't see. Is it insurance? I don't know. Right? Like, just buy the healthcare. Cutting to the chase, Jonathan Baran advocates for a paradigm shift where employers invest in primary care, adopt better benefit designs, more aligned to cost and quality so that members are incented toward better cost and quality, employee navigation services to guide employees to make more informed healthcare decisions. So again, by changing the focus from buying discounts to buying actual healthcare, Jonathan says, we can reverse the negative cycle and improve overall health outcomes. As I've said multiple times already, my guest today is Jonathan Baran. He has been, for a long time, a healthcare entrepreneur. Today he is co-founder and CEO of Self Fund Health in Wisconsin, committed to challenging the expensive healthcare system in Wisconsin. Self Fund Health, I am always so pleased to tell you, did make a really, really kind offer to help out RHV (Relentless Health Value) financially. You and the tribe here are really great folks who I truly, truly appreciate. So, please do support Self Fund Health if you are in Wisconsin. This podcast is sponsored by Self Fund Health today. Also mentioned in this episode are Self Fund Health; Cora Opsahl; Claire Brockbank; Eric Bricker, MD; Chris Crawford; Cynthia Fisher; Scott Haas; Peter Hayes; Matt McQuide; RxSaveCard; Mark Cuban; Ramy Khalil, MD; Candace Shaffer; and Tom Nash.   You can learn more at Self Fund Health and follow Jonathan on LinkedIn.   Jonathan Baran is a serial healthcare IT entrepreneur and the co-founder and CEO of Self Fund Health, a fast-growing health plan redefining how employers buy and manage healthcare. With a mission to eliminate waste and realign incentives in the healthcare system, Self Fund Health empowers employers to take control of rising costs by giving employees access to high-value providers at no cost, while replacing traditional insurance with real-time technology, dedicated nurses, and an aligned ecosystem of care. Prior to founding Self Fund Health, Jonathan was the co-founder and CEO of Healthfinch, one of the pioneering companies to build apps on top of electronic medical records. Healthfinch automated routine workflows for physicians using clinical data, significantly improving efficiency and patient care. Under Jonathan's leadership, Healthfinch raised over $15 million in venture capital and scaled to more than 50 employees. The company received national recognition, including being named a “Cool Vendor” by Gartner, a “Top Emerging Vendor” by KLAS, and one of Modern Healthcare's “Best Places to Work.” In 2020, Healthfinch was acquired by HealthCatalyst. Jonathan holds both a bachelor's and master's degree in biomedical engineering from the University of Wisconsin–Madison. He lives in Madison, Wisconsin, and continues to push the boundaries of innovation in employer-sponsored healthcare.   05:23 Where to start in reversing the flywheel. 06:57 Why investing in primary care is pivotal to containing healthcare costs. 10:02 EP453 with Claire Brockbank. 10:04 EP452 with Cora Opsahl. 10:07 EP457 with Cynthia Fisher. 10:12 EP365 with Scott Haas. 10:13 EP465 with Chris Crawford. 10:14 EP475 with Peter Hayes. 11:11 EP468 with Matt McQuide. 11:13 EP472 with Eric Bricker, MD. 12:14 “The most expensive thing in healthcare is the pen of the primary care doctor.” 13:04 How the role of the broker has to fundamentally change. 16:16 What will the single most challenging aspect of this restructuring become? 20:20 How self-funded employers can be amazing customers in containing the rising cost flywheel in healthcare. 22:56 How do EHRs and other medical record systems play into reversing the flywheel of rising healthcare costs? 23:57 Ramy Khalil, MD's post on interoperability. 24:59 Why is it important for employers to drive volume differently? 25:38 How Self Fund Health is helping in this regard.   You can learn more at Self Fund Health and follow Jonathan on LinkedIn.   @JonathanBaran discusses how to contain increasing #healthcarecosts on our #healthcarepodcast. #healthcare #podcast #financialhealth #patientoutcomes #primarycare #digitalhealth #healthcareleadership #healthcaretransformation #healthcareinnovation Recent past interviews: Click a guest's name for their latest RHV episode! Jonathan Baran (Part 1), Jonathan Baran (Bonus Episode), Dr Stan Schwartz (Summer Shorts), Preston Alexander, Dr Tom X Lee (Take Two: EP445), Dr Tom X Lee (Bonus Episode), Dr Benjamin Schwartz, Dr John Lee (Take Two: EP438), Kimberly Carleson, Ann Lewandowski (Summer Shorts), Andreas Mang and Jon Camire (EP479), Justin Leader (Take Two: EP433)  

Everyone says ASO is dead. They're wrong.In this video, I'm sharing 5 free ASO tools I personally use to help indie apps grow organically — no ads, no fluff. We used these exact tools to take a niche AI app from $100 → $80,000 in revenue, purely through keyword research and App Store traffic.This isn't your typical “download this tool” video. I walk you through how to spot winning keywords, what metrics to look for, and how we stack tools like Google Trends, AppFollow, and Fox Data to rank faster and grow revenue.

Everyone says ASO is dead. They're wrong.In this video, I'm sharing 5 free ASO tools I personally use to help indie apps grow organically — no ads, no fluff. We used these exact tools to take a niche AI app from $100 → $80,000 in revenue, purely through keyword research and App Store traffic.This isn't your typical “download this tool” video. I walk you through how to spot winning keywords, what metrics to look for, and how we stack tools like Google Trends, AppFollow, and Fox Data to rank faster and grow revenue.

In this episode, we're joined by Sharad Shankar, Founder of AndOr Communications Pvt Ltd, the team behind the viral AI photo editing app LightX, which has surpassed 50M installs on Android and 8M+ on iOS. Originally launched as a paid app, LightX transitioned to a subscription model in 2019 and has since evolved into a powerful, AI-driven platform for image generation and editing.An alumnus of the Indian Institute of Technology, Kanpur, Sharad's career spans roles in mobile engineering and building high-impact, user-focused products. In this conversation, Sharad shares his full growth playbook — from ASO, paid ads, and SEO to Web2App conversion strategies and cracking the Google Play featured placement.He also reveals how he led a team of 60+ to turn LightX into a breakout success. This episode is a must-watch for anyone building or scaling a mobile app in 2025 and beyond.You will discover:✅ How LightX went from a paid app to top-grossing AI subscription✅ Mobile growth playbook: ASO, ads, SEO, Web2App & more✅ The secret to getting featured on Google Play✅ Building user-first products with a strong USP✅ Managing & scaling a 60+ member teamLearn More:Explore LightX:Web Product: https://www.lightxeditor.com/ iOS App Store: https://apps.apple.com/us/app/lightx-photo-editor-retouch/id1400740705 Android App Store: https://play.google.com/store/apps/details?id=com.lightx&hl=en_IN Connect with Sharad:https://www.linkedin.com/in/sharad-shankar-796b773/ https://andor.in/Work with us: https://www.appmasters.comIndie App Santa: https://www.indieappsanta.comGet training, coaching, and community: ⁠https://appmastersacademy.com/*********************************************SPONSORSArcads is the fastest and best indie-friendly platform to create authentic, AI-powered UGC-style video ads — all from just text input.- Emotionally resonant, human-like videos- Perfect for app demos, testimonials, and paid social creatives- Built for speed, built to convertWhether you're launching or scaling, Arcads makes it easy to test and iterate video ads.Try it now: https://www.arcads.ai/?comet_custom=appmasters*********************************************Everyone's talking about web2app funnels - the breakthrough strategy maximizing mobile revenue. But building them in-house takes months of development. web2wave eliminates the complexity with their innovative all-in-one platform✅ AI funnel generator✅ powerful drag-and-drop quiz builder✅ streamlined payments✅ comprehensive analytics✅ smart A/B testing✅ and moreLaunch high-performing web2app funnels in days, not months.Visit https://web2wave.com/ to create your web2app funnel for free.*********************************************Follow us:YouTube: ⁠AppMasters.com/YouTube⁠Instagram: ⁠@App MastersTwitter: ⁠@App MastersTikTok: ⁠@stevepyoung⁠Facebook: ⁠App Masters⁠*********************************************

In this episode, we're joined by Sharad Shankar, Founder of AndOr Communications Pvt Ltd, the team behind the viral AI photo editing app LightX, which has surpassed 50M installs on Android and 8M+ on iOS. Originally launched as a paid app, LightX transitioned to a subscription model in 2019 and has since evolved into a powerful, AI-driven platform for image generation and editing.An alumnus of the Indian Institute of Technology, Kanpur, Sharad's career spans roles in mobile engineering and building high-impact, user-focused products. In this conversation, Sharad shares his full growth playbook — from ASO, paid ads, and SEO to Web2App conversion strategies and cracking the Google Play featured placement.He also reveals how he led a team of 60+ to turn LightX into a breakout success. This episode is a must-watch for anyone building or scaling a mobile app in 2025 and beyond.You will discover:✅ How LightX went from a paid app to top-grossing AI subscription✅ Mobile growth playbook: ASO, ads, SEO, Web2App & more✅ The secret to getting featured on Google Play✅ Building user-first products with a strong USP✅ Managing & scaling a 60+ member teamLearn More:Explore LightX:Web Product: https://www.lightxeditor.com/ iOS App Store: https://apps.apple.com/us/app/lightx-photo-editor-retouch/id1400740705 Android App Store: https://play.google.com/store/apps/details?id=com.lightx&hl=en_IN Connect with Sharad:https://www.linkedin.com/in/sharad-shankar-796b773/ https://andor.in/Work with us: https://www.appmasters.comIndie App Santa: https://www.indieappsanta.comGet training, coaching, and community: ⁠https://appmastersacademy.com/*********************************************SPONSORSArcads is the fastest and best indie-friendly platform to create authentic, AI-powered UGC-style video ads — all from just text input.- Emotionally resonant, human-like videos- Perfect for app demos, testimonials, and paid social creatives- Built for speed, built to convertWhether you're launching or scaling, Arcads makes it easy to test and iterate video ads.Try it now: https://www.arcads.ai/?comet_custom=appmasters*********************************************Everyone's talking about web2app funnels - the breakthrough strategy maximizing mobile revenue. But building them in-house takes months of development. web2wave eliminates the complexity with their innovative all-in-one platform✅ AI funnel generator✅ powerful drag-and-drop quiz builder✅ streamlined payments✅ comprehensive analytics✅ smart A/B testing✅ and moreLaunch high-performing web2app funnels in days, not months.Visit https://web2wave.com/ to create your web2app funnel for free.*********************************************Follow us:YouTube: ⁠AppMasters.com/YouTube⁠Instagram: ⁠@App MastersTwitter: ⁠@App MastersTikTok: ⁠@stevepyoung⁠Facebook: ⁠App Masters⁠*********************************************

Wed July 30, 2025 Audience: Any family with a DEE who has a kid who has seizures, yes SYNGAP1 is a DEE and you are always my first audience.   See #S10e133 if you are curious about DEE vs other names. https://curesyngap1.org/podcasts/syngap10/what-is-this-syngap1-illness-disease-syndrome-ndd-dee-mrd5-nsid-actually-called-s10e133/   Action: If your kid has motor seizures, fill out the screener and join this amazing study. Link here: https://www.resiliencestudies.com/emerald   A motor seizure is a seizure where you can see something moving – including head drops, drops, convulsive, etc. – only excluded seizures are absence, myoclonia and infantile spasms.  You don't need to figure this out, just fill in the screener, let the doctors figure it out.   Questions: Come to live webinar tomorrow, it will not be recorded, so you have to come register here: https://curesyngap1.org/resources/webinars/webinar-111-introduction-to-praxiss-emerald-study-for-syngap1-patients/   TRIAL. Any DEE patient with 4 motor seizures a month, minimum. Age 2-65.  Adults are you listening? 24 weeks (6 months) weeks, placebo controlled but everyone will get drug at some point in the trial. 28 weeks (7 months) week OLE, with a chance for expanded access, so if it works, you can stay on. Fully decentralized, you don't have to go to a site if you don't want to. One US site open so far in Bethesda, there will be others.  Int'l sites in 2026.  US ENROLLING NOW. DRUG. Lots of science and big words in the links below, but here is what you need to know as a parent. It's a liquid, can go oral or in a g-tube. There is no ramp up, you put it in and it works.  In terms of speed, think Lorazepam not Lamotrigine. It's potent and specific, which means small volume.  Roughly 1ml for 10 kg.  This will be a rounding error in the face of a normal SynGAPian med regime. Even though this is a sodium channel drug, it should benefit all DEEs b/c, good to clarify tomorrow, all seizures end with a hyperactive sodium channel firing and that is what Relutragine focuses on.   PRAXIS. Serious people, lots of work on Epilepsy.  Connected to SYNGAP1 and DEEs, just need to move faster on SYNGAP1 ASO! CSO is Steve Petrou, works with SRF AUS and knows they are waiting. KD and AN started a company for SCN2A and it was absorbed by Praxis, they are still there and are relentless. Work on both small molecules and ASO, this is a way for them to see our team in action.   Cool links: AES 2024 Story. https://eppro01.ativ.me/web/page.php?page=session&project=AES24&id=2894147 Embold read out: https://www.neurologylive.com/view/relutrigine-shows-promise-phase-2-embold-study-scn2a-dee-scn8a-dee FDA Breakthrough. https://www.globenewswire.com/news-release/2025/07/17/3117145/0/en/Praxis-Precision-Medicines-Receives-FDA-Breakthrough-Therapy-Designation-for-Relutrigine-for-the-Treatment-of-Seizures-Associated-with-SCN2A-and-SCN8A-Developmental-and-Epileptic-E.html More links. https://delta.larvol.com/Products/?ProductId=05ccb036-a308-4249-abf6-e03b120839da   Why am I doing this? We need better meds and the way to meds is through trials. We need to jump at every trial, every time. 3. This one is decentralized, so minimum burden. If you get in now, this will be over before it's ASO trial time, so you could do both. Our Syngapians with motor seizures tend to be our most severe, we have to make sure we find out if this drug can help.  All our kids may progress to this point.   See you at the webinar, fill out the screener now: https://www.resiliencestudies.com/emerald

In this episode, Stacey Richter discusses 'Three Surprising Ways Carriers Make Lots of Money' with Preston Alexander. The episode highlights how carriers leverage financial strategies—like using premium dollars as float, intracompany eliminations, and upcoding in Medicare Advantage—to enhance their profits.  The discussion emphasizes the importance for plan sponsors and policymakers to understand these tactics to better manage healthcare costs. Alexander advises collaborating with unbiased consultants who are experts in health plan design to navigate these complex financial dynamics effectively. === LINKS ===